HomeMy WebLinkAbout20M05 CAMPAIGN TREASURER'S REPORT SUMMARY
(1) , di /n_5 OFFICE USE ONLY
(2) a q� / / �` '/� 91A
aluCity of Miami Gardcns
_(( C" l-) ' YV f Reci.�ve*'40E-0
y the Office of oi City Clerr
Address (number and stre t) // __ Date: !b1�0atG' Time:NA) L 33 )
City, State, Zip Code By.�'
❑ Check here if address has changed (3) ID Number:
(4) Check appropriate box(es):
Candidate Office Sought: {�
Political Committee (PC)
F-1Electioneering Communications Org. (ECO) ❑ Check here if PC or ECO has disbanded
❑ Party Executive Committee (PTY) ❑ Check here if PTY has disbanded
❑ Independent Expenditure (IE) (also covers an ❑ Check here if no other IE or EC reports will be filed
individual making electioneering communications)
(5) Report Identifiers
Cover Period: From / C, I / To /`� / ,, Report Type M rj5
❑ Original ❑ Amendment ❑ Special Election Report
(6) Contributions This Report (7) Expenditures This Report
Monetary
Cash & Checks $ ) ��� ( � Expenditures $ I /
1
Loans $ Transfers to
Office Account $
Total Monetary $
Total Monetary $ 6
In-Kind $
(8) Other Distributions
$ ,
(9) TOTAL Mone ry Fontributions To Date (10) TOTAL Monetary Expe ditures To Date
(11) Certification
It is a first degree misdemeanor for any person to falsify a public record (ss. 839.13, F.S.)
I certify tharrma examin d tr r rt and it is true, correct, and complete:
(Type name) S i 1'1')io I (Type name) ��—
❑ I ,vi I(only fbr I Tre urer D putt'Treasurer C di Ch ' rson(only for 131 and PTY)
or lectio ng )
/ X
Sign re Signatur
DS-DE 12(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS
CAMPAIGN TREASURER'S REPORT- ITEMIZED CONTRIBUTIONS
(1) Name j 5 �/ in'1 I o 5 (2) I.D. Number
(3) Cover Period through , /,_aL P (4) Page of
(5) (7) (8) (9) (10) (11) (12)
Date Full Name
(6) (Last, Suffix, First, Middle)
Sequence Street Address& Contributor Contribution In-kind
Number City, State,Zip Code TVpe Occupation Type Description Amendment Amount
00 / MAID 41 r
Z D0/ 0 D
s-
�� 7 33AS
Camel n 51�,
A/4 �/ Fl-
l.� / / - &;
30� �7 � e 5
a5_13 6 4PD FL �wf 5
- o�
le
DS-DE 13(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES
CA PAI N !RE URE 'S REPORT- ITEMIZED EXPENDITURES
(1) Name f (2) I.D. Number
(3) Cover Perio a6-/ / through /J(/ c�b (4) Page of
(5) (7) (8) (9) (10) (11)
Date Full Name Purpose
(6) (Last,Suffix, First, Middle) (add office sought if
Sequence
Street Address& contribution to a Expenditure
Number City, State,Zip Code candidate) Type Amendment Amount
��
_1
�/J
n5 S
Coa). L4
12-
CPA) ,
a c) F
�- Q�e 14 ELL
DS-DE 14(Rev. 11/13) SEE REVERSE FOR INSTRUCTIONS AND CODE VALUES